Genomic advances outpace physicians

Training doctors called top priority

As fast as knowledge of human genetics is advancing, the next challenge may be training doctors to make use of it.

Experts at a La Jolla conference on “genomic medicine” spoke yesterday about a future in which doctors sequence a patient’s genome, analyze any mutations they find and then create a “custom cocktail” of treatment.

But for that to happen, the physicians on the front lines of medicine will need to dramatically change their approach.

“We know it’s a tough challenge,” said Dr. Eric J. Topol, director of La Jolla’s Scripps Translational Science Institute. “Even those physicians who’ve graduated in recent years have not been able to keep up with this field.”

The event, dubbed “The Future of Genomic Medicine,” drew about 400 people to La Jolla’s Neurosciences Institute for two days of discussions on topics such as “Rapid Individual Sequencing” and “Extrapolating Genomic Data for Prevention of Diseases.”

The group is about evenly split between physicians with an interest in the area and the “genomicists” advancing the science, Topol said.

Greg Lucier, chief executive of the Carlsbad biotechnology company Life Technologies, said there is a question as to whether there will need to be a new specialty of molecular medicine to make the best use of approaches that will emerge.

His company is a top supplier of the sequencing machines that drive the work. Lucier said a priority is to make the machines smaller and more practical to enable widespread use in a variety of settings.

“The technology won’t be the issue,” Lucier said. “It will really be our ability to grasp the technology and do more with it.”

Topol pointed to an American Medical Association survey that found only one in 10 doctors believes he or she has enough knowledge of genetics to use it in a medical practice.

He said one initiative to change this will be a new Association of Genomic Medicine, funded initially with a grant from Life Technologies. Its mission will be to educate the medical community. This will include online learning programs with credentials for physicians who complete them.

“A whole revolution has to come about,” Lucier said. “Most doctors don’t understand genomics. They’re not trained in it in the traditional medical schools. And yet here we go, really taking medicine to an entirely different level.”

Life Technologies this week also announced a study that aims to put genomic technology to practical use by sequencing the genomes of 14 breast cancer patients. That’s possible only because improvements in technology have slashed the cost of sequencing a genome to about $6,000 on the company’s latest instrument.

Topol said that while much of the public may not be aware of progress in genomics since the much-publicized initial sequencing of a human genome a decade ago, a lot has happened.

“A lot of people thought, ‘Well here it is almost 10 years later and what do we have to show for it?’ ” he said. “But I think it’s pretty clear … that things have really taken off and we’re at a tipping point.”